1. Washington State Rethinking Care Project July 22, 2008

2. 2 WHERE WE HAVE BEEN Chronic Care Management  Medicaid only, Fee-for-service SSI adults  60,000 people potentially eligible  Highest 20% risk  Voluntary enrollment  3 Distinct Approaches tailored to 3 populations

3. 3 WHAT WE WANTED TO ACCOMPLISH Chronic Care Management  Improved health literacy and self- management of chronic conditions  Interruption of the spiral of increasing cost and decreasing health status

4. 4 WHERE WE ARE NOW Chronic Care Management Evaluation  Cost analysis,  clinical measures and  clinical file review Report to the Legislature Dec 2008  Information will be very preliminary, especially the cost analysis  Will have both qualitative and quantitative measures

5. 5 EFFORTS TOWARD Medical Home Development King County Care Partners have built a Medical Home network as part of local care management Using Washington State definition Accessible and Continuous Coordinated and Comprehensive Client-Centered Compassionate and Culturally Effective complete WA State Medical Home definition http://www.medicalhome.org/ 4Download/ keymessages2007.pdf

6. 6 Medical Home Efforts Workgroup  Cross-agency workgroup and steering committee convened in 2007  Goal to expand medical home for aged, blind & disabled adults & children  RFI to providers completed and being analyzed/compiled now

7. 7 MEDICAL HOME EFFORTS Cross Agency and National  Commonwealth grant supporting a multi-stakeholder work group to improve medical home (08 - 09)  NASHP and NASMD both sponsoring conferences on medical home  Participate with DOH on collaborative development for 2009  Participate with HCA on reimbursement study

8. Shaping the Future Rethinking Care – Opportunity to Integrate Two Approaches

9. 9 CHCS RETHINKING CARE Taking it to the Next Level  Build upon current efforts and existing infrastructure  Target 5% of clients driving 50% costs  Interventions – Medical home improvement Care management New focus on mental health & CD services  Utilizing current Workgroups  Steering Committee composed of Cross Administration Directors  Use national resources for learning (Commonwealth, NASHP, CHCS)

10. 10 MULTIPLE STRATEGIES to Build Synergy  Medical Home  CCMP  ER Grant – Directs $$ to CHC’s  Health Navigator  Children’s Health Improvement Project  May Expand Managed Care for SSI Kids  GAU-MH Pilot  WMIP

11. 11 RETHINKING CARE Next Steps  HRSA EC has endorsed project  Will recommend two project sites to Steering Committee  Kick off meeting planned for September  Target 1 st project start January 1, 2009

12. 12 Rethinking Care Next Steps Rethinking Care Steering Committee Rethinking Care Workgroup Medical Home Team Chronic Care Management Evaluation Workgroup